Immigrant Health in Canada
Canada is a country that is often thought to be an inviting
place, with freedoms and accessibilities not granted as readily in other
countries. Many may consider it the “nicer” of the two main North American
countries. As an immigrant to the country, I chose Canada as a place to further
my education and I chose to stay because I felt like it was where I was meant
to be right now.
Canada has seen an influx in the number of immigrants entering
the country. In fact, 2016 saw the highest number of immigrants since 2000 with
over 323,000 persons. That year 157, 990 men and 165,183 women entered and 2017
had 131,753 men and 140, 913 women immigrating. (Statista, 2017)
Persons may enter the country through various ways,
including:
- International Students
- Temporary Workers
- Live-in Caregiver
- Refugees
(I will be focusing this post on International Students and
Refugees).
Healthy Immigrant
Effect (HIE)
Due partly to the rigorous screening process implemented by
the Canadian government for immigration, many immigrants to the country arrive
in very good health. “Most (> 90%) migrants arriving in Canada report very
good to excellent health and display health characteristics that equal or
exceed those of Canadian residents. This observation is known as the healthy
immigrant effect and has been the subject of frequent study”. (Gushulak,
Pottie, Roberts, Torres & DesMeules, 2011)
The authors further note that this effect is lost over time,
the longer they remain in Canada.
Refugees
Unfortunately, of the group mentioned above, this effect is
not usually seen with Refugees. It is common knowledge that Refugees are often
fleeing their countries due to war, devastation and/or persecution, and as
such, many of them enter with health issues. These unique health issues,
combined with cultural and language barriers, require specialized services in
many cases.
Sarkonak (2018) wrote an article that included the words of
Dr. Stan Houston, who stated “An ideal refugee-dedicated clinic could address
trauma, exotic disease, tuberculosis, mental health, and have cultural and
language competency”.
However, there have been challenges imposed unto refugees in
regard to healthcare access and policy.
This new evidence suggests that
the cuts to health coverage have, in particular, denied refugees access to
primary and preventive care. In addition to being medically irrational and
essentially unfair, these cuts are economically irresponsible, because refugees
are presenting to emergency departments with acute conditions that could have
been prevented or treated in primary care at an earlier stage and at a lower
cost. (Stanbrook, 2014)
International
Students
Persons who leave their country to pursue studies in another
country are called International Students. These persons can spend up to 4
years or more in Canada. Therefore, proper access to healthcare is important
during this time. However, differences among provinces can make this more
difficult for some than others. Some provinces (like Alberta, British Columbia,
Saskatchewan) offer provincial health coverage to international students.
Others (such as Ontario, Quebec and Nova Scotia) do not. (Devine, n.d.)
Students often have to pay premium prices to be provided
with coverage for basic healthcare services (not including optical and dental
services). I recall having to pay up to $1000/year as an international student
in New Brunswick (I studied there before they implemented the provincial health
care coverage for international students).
In a recent article posted on the CBC News website, Glowacki
(2018) wrote on the recent privatization of health care coverage for international
students in Manitoba, and the possible repercussions for this action. “International
students in Manitoba who become seriously or terminally ill may be forced to
return to their countries of origin or risk losing coverage under
their new private health insurance plan.”
The article includes a quote by Dele Ojewole, chair of the
Canadian Federation of Students for Manitoba where he expresses, "International
students pay taxes as regular domestic students. International students
contribute to the economy of this province. There's no reason that they
shouldn't be extended the same rights or the same health care." (Glowacki,
2018)
Final Thoughts
In my first semester of university, during a mid-semester
exam, I began to display syncope-like symptoms. My university and the hospital
were right next to each other, but an ambulance was called to take me in. Due
to this emergency situation, I did not have my international health coverage
card on me. I remember being put on a stretcher bed where I spent anywhere
between 2-3 hours there. I was 17 years old and had only moved to Canada less
than 2 months before and had no family with me. I recall a nurse mentioning how
young I was to be on my own and in university, but what I do not recall was any
testing to determine the cause of my symptoms. There was no ECG, no blood test,
no urine test. I was given a cup of water and released from care, but not
before a physician came in with two residents (I think) and asked to do an abdominal
ultrasound for practice.
Looking back at this situation, I realize that I was a
vulnerable person and did not receive adequate care (possibly because they
thought I lacked coverage, who knows?)
Within the Immigrant “pool” there are large variances in
health status. However, are these people entering the country being given the
same treatment as Canadian-born residents? Or is this [sometimes] vulnerable
group being marginalized and under-served?
References:
Devine, E. (n.d.).
Guide to Health Insurance in Canada.
Retrieved from: https://www.studyinternational.com/help-and-advice/guide-to-health-insurance-in-canada
Glowacki, L.
(2018). Seriously ill international students could be forced to leave Manitoba
under new health insurance plan. Retrieved from https://www.cbc.ca/news/canada/manitoba/international-students-health-insurance-1.4807343
Gushulak, B.,
Pottie, K., Roberts, J., Torres, S., & DesMeules, M. (2011). Migration and
health in Canada: health in the global village. Canadian Medical
Association Journal, 183(12), E952-E958. doi:
10.1503/cmaj.090287
Sakornak, J.
(2018). 'It’s not refugee-centred health care': Mayor to pen letter to health
officials with concerns. Retrieved from https://edmontonjournal.com/news/local-news/its-not-refugee-centred-health-care-mayor-to-pen-letter-to-health-officials-with-concerns
Stanbrook, M.
(2014). Canada owes refugees adequate health coverage. Canadian Medical
Association Journal, 186(2), 91-91. doi: 10.1503/cmaj.131861
Statista.
(2017). Immigrants in Canada 2000-2017. Retrieved from https://www.statista.com/statistics/443063/number-of-immigrants-in-canada/
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